General Definitions

Most insurance companies use certain words in their Policy and Policy Schedule, which have a specific meaning and are typically shown under the heading of General Definitions in the Policy. They have this meaning wherever they appear in the Policy or Policy Schedule.

Accident, Accidental - means a sudden, unforeseen, uncontrollable and unexpected physical event to the Insured Person caused by external, violent and visible means occurring under the circumstances described in a Hazard applicable to that person.

Age - means the Age of the Insured Person on his / her most recent birthday as per the English calendar, regardless of the actual time of birth.

Aggregate Limit - The maximum liability under the Accidental Death and Dismemberment or the Permanent Total Disability or the Loss of Use benefits of this Policy in the aggregate in respect of all claims by or on behalf of all Insured Persons, shall not exceed the maximum aggregate limit stated in the Schedule, and if at any time the total value of unpaid claims would, if paid, result in this aggregate limit being exceeded, the individual benefits attributable to those outstanding claims shall be reduced pro rata as necessary to ensure that this maximum aggregate limit is not exceeded

Certificate of Insurance - means the document issued by the insurer detailing the effective date, installment date, Insured Person(s), benefits, sums insured, Deductible, Franchise, premium and more generally all special condition(s) and or endorsement(s).

Common Carrier - means any civilian land or water conveyance or Scheduled Airline in each case operated under a valid license for the transportation of passengers for hire.

Day - means a period of 24 consecutive hours.

Daily Benefit - means the amount payable for each Day spent in the Hospital

Deductible - means the amount of expenses or the number of Days to be paid or supported by the Insured Person before the Policy benefits become payable.

Disease - means an illness or affliction of the body having a defined and recognized pattern of symptom(s) which causes more than temporary indisposition and which illness or affliction first manifested itself and was contracted during the Trip, under the circumstances described in a Hazard.

Franchise - means the amount of expenses or the number of Days to be paid or supported by the Insured Person beyond which the Policy benefits become payable retroactively.

Hospital - means a medically recognized establishment:

a) the primary function of which is to provide for the care and treatment of sick or injured persons, and
that has a staff of one or more Physicians actually available on the premises at all times, and

b) that provides a 24-hour nursing service and has at least one qualified and registered professional nurse present and on duty at all times, and

c) that has organised diagnostic and surgical facilities, either on its own premises or in facilities available to the Hospital on a pre-arranged basis, and

d) is not, except incidentally to its primary function, a clinic, nursing home, rest home, or convalescent home for the aged, or any similar institution.

Injury - means bodily Injury caused solely, independently and directly by Accident (as defined in the Policy) and occurring during the Trip, under the circumstances described in a Hazard while the Policy is in force.

Inpatient - means a person: (a) who is confined in a Hospital as a registered bed patient; and (b) for whom at least one Day's room and board is charged by the Hospital.

Insured Journey- means any journey undertaken, while on the Business of the Policy Holder, during the Insured Period:

which commences when the passenger boards the Common Carrier for onward journey and terminates when he disembarks on return to the Republic of India Your usual Country of residence or the contracted expiration date whichever earlier. Or which lasts or is expected to last for Upto 180 Days or less.

Such Insured Journey shall be deemed to have commenced when the Insured Person leaves his residence or place of regular employment for the purpose of going on such Insured Journey, whichever last occurs, and shall continue until such time as he returns to his residence or place of regular employment, whichever first occurs

However, the Insured Journey is deemed to exclude any period of time during which the Insured Person is on authorized leave of absence or vacation or travel to and from the Insured Person's place of regular employment.

Insured Period(s) - means with respect to the Policy, the period commencing with the Effective Date of the Policy and terminating with the Expiration Date of the Policy as stated in the Policy Schedule and any subsequent period for which the Policy may be renewed.

Insured Person - means the Insured Person up to Age upto 65 , or eligible Spouse and/or Eligible Children detailed in the Policy Schedule as being eligible to become insured under this Policy and for whom a Proposal and Declaration Form for insurance has been received from the Policyholder and approved by the insurance company.

Land/Sea Arrangements - means pre-paid travel arrangements for a scheduled tour, trip or cruise included within the description of covered Trips on the Proposal and Declaration Form and arranged by a tour operator, travel agent, cruise line or other organization.

Medically Necessary - means medical services or supplies which: (a) are essential for diagnosis, treatment, or care of the covered loss under the applicable benefit for which it is prescribed or performed; (b) meets generally accepted standards of medical practice; and (c) is ordered by a Physician and performed under his or her care, supervision, or order.

Period of insurance - the period commencing on the Policy Effective Date and expiring on the Policy Effective Date as referred to in the Schedule

Period of Confinement - means a period of consecutive Days of confinement as an Inpatient caused by an Accident, Injury, Disease or Sickness. However, successive confinements as an Inpatient caused by or attributable to the same Accident, Injury, Disease or Sickness are considered to be part of the same Period of Confinement, unless the discharge date for the prior confinement is separated from the admission date for the next confinement by at least 30 Days.

Only one Daily Benefit is provided for any one Day of confinement, regardless of the number of Accidents, Injuries, Illnesses or Sicknesses for which the confinement is required

Physician - means a licensed medical practitioner acting within the scope of his license and who holds a degree of a recognized institution and is registered by the Authorised Medical Council in the Republic of India. The attending Physician will not be (a) an Insured Person or (b) Your Immediate Family Member. The term Physician would include surgeon.

Policy Schedule - means the Policy Schedule attached to and forming part of the Policy.

Policyholder - means the physical person(s) or the entity named in the Policy Schedule who executed the Policy Schedule and is (are) responsible for payment of premiums.

Policyholder Aircraft - means any aircraft with a current and valid Airworthiness Certificate and owned, leased or operated by the Policyholder.

Pre-existing Condition - a condition for which care, treatment, or advice was recommended by or received from a Physician or which was first manifested or contracted within a period upto 2 years preceding the Insured Person's Effective Date of Coverage, or a condition for which hospitalization or surgery was required within a period upto 5 years preceding the Insured Person's Effective Date of Coverage as specified in the Policy Schedule.

Professional Sport - means a sport, which would remunerate a player in excess of 50% of his or her annual income
as a means of their livelihood.

Proposal and Declaration Form - means any initial or subsequent declaration made by the Policyholder/ Insured Person and is deemed to be attached and which forms a part of this Policy.

Reasonable and Customary Charges - means a charge which: (a) is charged for medical treatment, supplies or medical services that are Medically Necessary to treat Your condition; (b) does not exceed the usual level of charges for similar medical treatment, supplies or medical services in the locality where the expense is incurred; and (c) does not include charges that would not have been made if no insurance existed.

Scheduled Airline - means any civilian aircraft operated by a civilian scheduled air carrier holding a certificate, license or similar authorization for civilian scheduled air carrier transport issued by the country of the aircraft's registry, and which in accordance therewith flies, maintains and publishes tariffs for regular passenger service between named cities at regular and specified times, on regular or chartered flights operated by such carrier.

Serious Injury or Sickness - means Injury or Sickness certified as being dangerous to life by a legally qualified Physician while the Policy is in force.

Sickness - means illness first manifested and contracted during the Trip, and commencing, under the circumstances described in a Hazard while the Policy is still in force.

Single Trip Insurance - means the Trip specified on the Proposal and Declaration Form and Policy Schedule for which the Effective Date and Expiration Date are specified on the Proposal and Declaration Form and Policy Schedule and commences when the passenger boards the aircraft for onward overseas journey and terminates when he disembarks on return to the Republic of India or Expiration date whichever is earlier.

Sojourn and Personal Deviation, Sojourn or Personal Deviation - means non-business travel or activities undertaken While on the Business of the Policyholder but unrelated to furthering the business of the Policyholder.

Sound Natural Teeth - means natural teeth that either are unaltered or are fully restored to their normal function and are Disease-free, have no decay and are not more susceptible to Injury than unaltered natural teeth.

Special Hospital - means a Hospital or group of Hospitals specifically named in this Policy by endorsement.

Specialized Aviation Activity - means an aircraft while it is being used for one or more of the following activities:

acrobat or stunt flying

racing

any endurance tests

crop dusting

crop spraying

fire fighting

exploration

pipe line inspection

power line inspection

any form of hunting

bird or fowl herding

aerial photography

banner towing

any test or experimental purpose

any flight which requires a special

crop seeding

permit or waiver from the authority having jurisdiction over civil aviation, even though granted

any flight on a rocket-propelled or a rocket-launched aircraft

Spouse - means Your legal husband or wife, who is between the Ages of 18 and 65 years old, and is living in Your residence.

Traveling Companion - means up to two (2) named person(s) who is/are booked to accompany the policy holder on the Trip

Trip - means any Insured Journey during the Insured Period: which starts and finishes in The Republic of India and involves a destination(s) outside The Republic of India; and which lasts or is expected to last for: upto 180 Days or less.

Usual and Customary charges - means a reasonable charge which is : 1) usual and customary when compared with the charges made for similar services and supplies; and 2) made to persons having similar medical conditions in the locality of the Provider. No payment will be made under this policy for any expenses incurred which in the judgement of the Company are in excess of Usual and Customary Charges.

War - means war, whether declared or not, or any warlike activities, including use of military force by any sovereign nation to achieve economic, geographic, nationalistic, political, racial, religious or other ends.

While on the Business of the Policyholder - means while on assignment by or at the direction of the Policyholder for the purpose of furthering the business of the Policyholder, but does not include any period of time: (1) while the Insured Person is working at his or her regular place of employment; (2) during the course of everyday travel to and from work; (3) during an authorized leave of absence or vacation.

DISCLAIMER: These defintions are typical for travel insurance policy for any Indian insurance company. For exact definitions applicable for your insurance vendor, please see the applicable policy's terms and conditions.